A literature review has found that while orthoses can help improve the gait and balance of patients with Charcot-Marie-Tooth disease, patient compliance is low. The open-access study, “The Role of Orthotic Service in Modern Rehabilitation of Patients with Charcot-Marie-Tooth Disease,” was published in July in the Journal of Biosciences and Medicine.
The researchers conducted a meta-analysis of 412 scientific papers to determine the effectiveness of orthotic management of the condition and the influence of orthoses on balance and gait; 34 met the inclusion/exclusion criteria.
Several of the studies found that the use of orthoses was associated with an improvement in walking balance and performance, preventing the foot from falling and reducing the frequency of tripping, and improvement in restoring bone-joint interactions. One study indicated that the use of orthoses was associated with an increase in gait velocity, particularly in patients whose devices were made of polypropylene and silicone. Another concluded that AFOs improved balance and gait performance, particularly when the orthoses compensated for specific muscle deficits, and reduced foot drop and compensatory movements. Some studies, however, did not find an association between orthoses and patient improvement, which indicated a need for further research, according to the research team.
The studies also showed that compliance to orthosis wear was as low as 20 percent in CMT patients. The authors suggested that noncompliance stems from inadequate patient education about the device and negated the goal of early intervention, as many of the symptoms have the greatest increase in prevalence and impact in the first decade of the symptoms.
